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Please print or type.(Form designed For use an elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS If Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFESTUS L _ - 018170288 JJ K 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) �CRTiFIEL, CENTEF 7710 MURRAY DRIVE 1. ""'N v �r. Generator's Phone: ^9 478-9971 6.Transporter i Company Name U.S.EPA ID Number 'JAL SERVICES , 036 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address U.S.EPA ID Number �>SuF,U RESC;uR,�E RCCOVERY 3150 E. PICO BLVD. _*DS ANGELES CA Facility's Phone: c 10 - . r CAD 0 0 3 2 5 2 4 0 5 9a 9b.U.S.DOT Description(including Proper Shipping Name..Hazard Class.ID Number, 10.Containers 11.Total 12.Unit 13.Waste Codes HM and Packing Group(if any)) No. Type Quantity Wt./Vol. 0 1. A _3�). 4AilL FLAMMABLE SJuuS. JRGAtNC.N.O.S..(PAINT x �OILDS/DESP,IS) 41. PGII UJ 3 2- P 2."JON-RCRA HAZARDOUS WASTE.SOLIDS(WATERBORNE 35 SOILDS/DEBRIS) fi 300 3. 4. 14.Special Handling Instructions and Additional Information EMERGENCY CONTACT CHEMTREC 1-800-424-9300 WOES TERMINAL:CERES CS NAE RG#961 133.962 i:1 ' r'ROFILE;a 961 19090067 PAINT SOILDS/DEBRIS 962 1909008C W.ATc PEOP.NE SOLIDSC*P5 100872k'APPF P RI6 pPE 15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, marked and labeledlplacarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and I am the Primary Exporter.I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is true. XtorsKe rs Pnted/Typed` a Si a re ' Month Day Year VIr -J 16.Intemational Shipments r� -II F-- C Import to U.S. u Export from U.S. Port of entry/exit: Transporter signature(for exports only): Date leaving UA.: W 17.Transporter Acknowledgment of Receipt of Materials Trans rt1 Printe Typed meC A Signature Monntth Day Year U01 rain 1 /Yi 19 ZQ Transporter 2 PrireliTypel Name Signature Month Day Year H 18.Discrepancy 18a.Discrepancy Indication Space Quantity U Type ❑Residue Partial Rejection Full Rejection Manifest Reference Number: 18b,Alternate Facility(or Generator) U.S.EPA ID Number J U LL Facility's Phone: W 18c.Signature of Alternate Facility(or Generator) Month Dav Year t- Q Z y19.Hazardous Waste Report Management Method Codes(i.e-:Ades for hazardous waste treatment,disposal,and recycling systems) p 13. 4. 20.Designated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Pdnted/Typed Name Signature Month ie C Da EPA Form 8700-22(Rev.3-05) Previous ediTions are obsolete. DESIGN D FA ITYTO DESTINATION STATE(IF REQUIRED)